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Brazilian study: corticoid reduces severity of covid-19 effects

Aline Leal

Dexamethasone has shown positive results in ICU patients.

Research carried out by a group of Brazilian hospitals and research institutes has shown that the use of corticosteroid anti-inflammatory dexamethasone decreases the days with artificial respiration in adult hospitalized patients with severe acute respiratory syndrome caused by covid-19. The study was published today (2) in the scientific journal Journal of the American Medical Association (Jama).

According to the research, the number of days off the artificial respirator was greater in patients treated with dexamethasone (mean of 6.6 days) than in the control group (mean of 4 days). The increase in time off the artificial respirator means less risk of complications resulting from the stay in intensive care units (ICU), bed release and savings in human and financial resources.

The research was carried out by the Coalizão Covid-19 Brasil group, formed by Hospital Israelita Albert Einstein, HCor, Hospital Sírio-Libanês, Hospital Moinhos de Vento, Hospital Alemão Oswaldo Cruz, Beneficência Portuguesa Hospital of São Paulo, Brazilian Clinical Research Institute (BCRI) and Brazilian Network of Research in Intensive Care (BRICNet).

The study took place from April 17 to July 21. 299 patients with severe acute respiratory syndrome caused by covid-19 who underwent mechanical ventilation (artificial respiration) in 41 Brazilian ICUs participated.

By drawing lots, patients received dexamethasone and standard clinical support (151 patients) or only standard clinical support (in the control group, with 148 patients). Dexamethasone was used intravenously at a dose of 20 milligrams (mg) for 5 days and 10 mg for 5 days.

According to the Brazilian Society of Endocrinology and Metabology, the clinical application of dexamethasone is frequent, mainly due to its anti-inflammatory effects. However, its action can cause several side effects, the most common of which are elevated blood glucose, increased blood pressure, weight gain, swelling and, with prolonged use, osteoporosis and adrenal insufficiency.

According to the Brazilian research, there was no evidence of a greater risk in the treatment with dexamethasone in relation to new infections, glucose changes and other serious adverse events. The drug, however, should only be taken on medical advice.

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